August 2020 | Reviewed by: Jon Saito, MD and Rafael J. Sepulveda, MD
What is bruxism?
Grinding or clenching teeth during sleep is known as sleep-related bruxism. It is common for your jaw to contract while you sleep. When these contractions are too strong, they produce the sound of tooth grinding. This can cause dental damage by wearing your teeth down. In the most severe cases, hundreds of events can occur during the night. In milder cases, the grinding may vary from night to night.
Severe bruxism may briefly disturb your sleep. Only at rare times will it cause you to fully wake up. Loud sounds caused by the grinding of teeth can be very unpleasant. This can also disturb the sleep of a bed partner. It can occur during all stages of sleep. It is most common in stages one and two of non-REM sleep.
The cause of sleep-related bruxism is unclear but has been associated with stress, genetics, medications, and sleep-disordered breathing.
What are symptoms of bruxism?
The following are signs of bruxism:
- Tooth pain
- Jaw muscle pain
- Mouth and facial pain
- Limited jaw movement
- Damaged or worn teeth
- Sore gums
- Headaches
You may not know that you have it unless a family member or bed partner hears the noise. The rate of bruxism seems to be highest in children. About 14% to 17% of children have it. It can begin as soon as a child’s upper and lower teeth have come through the gums. Around one-third of children with bruxism will still have it when they are adults. About 8% of young to middle-aged adults have it. The rate continues to decrease with age.
Some people may have it every night for most of their lives. Dentures that are often used in the elderly may dampen the sound of grinding. This can keep the bruxism from being detected. It seems to affect men and women at the same rate. It tends to occur in families. From 20% to 50% of people with bruxism have at least one family member with a history of grinding his or her teeth.
What are risk factors for bruxism?
Your personality type can raise your chance of having bruxism. People who are highly motivated and driven tend to have a higher rate of it. It can also be caused by stress and anxiety. This may be due to a life event or pressure at school or work.
The use of cigarettes, alcohol, or caffeine before sleep may increase tooth grinding.
Secondary sleep-related bruxism is often found in children with cerebral palsy and those who are developmentally disabled.
How do you know if you have it?
- Do you grind or clench your teeth while you sleep?
- Do you have one or more of the following signs?
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- Damage or wear to the teeth
- Jaw discomfort, fatigue, or pain
- A locked jaw when you wake up
If you answered yes to these questions, then you might have sleep-related bruxism.
It is also important to know if there is something else that is causing your sleep problems. They may be a result of one of the following:
- Another sleep disorder
- A medical condition
- Medication use
- A mental health disorder
- Substance abuse
How to diagnose bruxism?
You should not be alarmed if you only grind your teeth from time to time. But regular tooth grinding can cause serious damage. Your medical provider or a counselor can help you find ways to deal with the stress that may be causing the bruxism. You may also need to see a dentist if your tooth grinding is severe.
First, your medical provider will need to know when your bruxism started. She will also want to know what else has been going on in your life. Share any sources of stress that you are dealing with. Your medical provider will need to know your complete medical history. Be sure to inform her of any past or present drug and medication use. Also, tell her if you have ever had any other sleep disorder.
Keeping a sleep diary for two weeks can help a medical provider see your sleeping patterns. This information gives clues about what is causing your problem and how to correct it.
Your doctor may have you do a sleep study, but this is rarely needed to detect bruxism alone. This study is called polysomnography. It charts your brain waves, heartbeat, and breathing as you sleep. It also records how your arms and legs move. This will show if there are other disorders, such as sleep apnea, that are causing your sleep problems.
The best sleep study will also record your sleep on video. This will help show if you grind your teeth or do anything unusual during the study.
How to treat bruxism?
An oral appliance can be used to protect your teeth while you sleep. It is usually made of soft plastic and fits over your teeth like a mouthguard. Some are made so you can mold them at home to fit your mouth. You simply boil the device and then bite down to shape it to your mouth. Most often you will need to go to a dentist for a proper fitting.
Stress often causes bruxism or makes it worse. You can make efforts to reduce or manage the stress in your life. This can help prevent bruxism and reduce the jaw pain that results from it.
There are many ways to handle stress. Self-help strategies are common. Relaxation training and biofeedback may also be helpful. These are types of cognitive behavioral therapy. A counselor or therapist may also be able to help you.